Global Medical Ceramics Market Size, Share, Trends, Growth, & Growth Analysis Report By Type, Application, End-user & Region (North America, Europe, APAC, Latin America, Middle East and Africa) – Industry Forecast (2024 to 2033)
The global medical ceramics market is projected to grow from USD 18.03 billion in 2024 to USD 27.92 billion by 2033, at a CAGR of 4.98%.
Medical ceramics refer to a class of inorganic, non-metallic materials engineered for use in biomedical applications due to their biocompatibility, corrosion resistance, mechanical strength, and thermal stability. These materials are widely utilized in orthopedics, dental implants, surgical instruments, and implantable devices such as hip and knee prostheses. The most commonly used ceramic materials in medical applications include alumina, zirconia, and hydroxyapatite.
The global demand for medical ceramics has been rising steadily, driven by an aging population, increasing prevalence of musculoskeletal disorders, and growing preference for long-lasting implant materials. According to the World Health Organization, musculoskeletal conditions affect more than 1.7 billion people worldwide, significantly contributing to the need for orthopedic implants. Also, as per the International Osteoporosis Foundation, one in three women over the age of 50 will experience osteoporotic fractures, further intensifying the requirement for durable and reliable implant solutions such as medical ceramics.
In recent years, technological advancements in additive manufacturing and bioactive ceramics have enabled the development of patient-specific implants, enhancing surgical outcomes and reducing recovery times. As per the National Institutes of Health, bioactive glass ceramics have shown promising results in bone regeneration therapies, opening new avenues for innovation in regenerative medicine. These factors collectively underscore the critical role of medical ceramics in modern healthcare infrastructure and their expanding scope across both therapeutic and diagnostic domains.
A key driver propelling the growth of the medical ceramics market is the escalating demand for orthopedic implants, primarily due to the rapidly aging global population. As individuals grow older, they become more susceptible to degenerative joint diseases such as osteoarthritis and osteoporosis, which often necessitate surgical interventions like total joint replacements. According to the United Nations Department of Economic and Social Affairs, the global population aged 65 years or older is projected to reach 1.5 billion by 2050. This demographic shift has significantly increased the number of orthopedic procedures being performed annually.
Ceramic-based implants, particularly those made from alumina and zirconia, are increasingly preferred over traditional metal-on-metal or metal-on-polyethylene implants due to their superior wear resistance and reduced risk of adverse biological reactions. For instance, as per data published by the Journal of Arthroplasty, ceramic-on-ceramic hip implants exhibit lower wear rates approximately 0.1 mm per year compared to other materials. This not only enhances implant longevity but also reduces the likelihood of revision surgeries, which are both costly and physically taxing for elderly patients.
In addition, as per the American Academy of Orthopaedic Surgeons, over 4.5 million Americans are living with at least one hip or knee replacement, and this number is expected to rise substantially in the coming decades. As life expectancy increases and active lifestyles among seniors become more common, the demand for high-performance orthopedic implants made from medical ceramics is set to surge even further.
Another significant driver fueling the expansion of the medical ceramics market is the rising prevalence of dental disorders combined with the growing popularity of cosmetic dentistry. Dental ceramics, including porcelain and zirconium dioxide, are extensively used in crowns, bridges, veneers, and dental implants due to their aesthetic appeal, biocompatibility, and durability. According to the World Health Organization, approximately 3.5 billion people globally suffer from oral diseases, with untreated dental caries affecting nearly 2.3 billion individuals.
The increasing awareness regarding oral health, coupled with rising disposable incomes and insurance coverage for dental procedures in developed regions, has led to a surge in elective dental treatments. As per the Global Burden of Disease Study, tooth decay remains one of the most prevalent non-communicable diseases worldwide, contributing to a higher demand for restorative dental solutions. In the U.S., according to the American Dental Association, over 15 million dental crowns are placed annually, many of which utilize ceramic materials for their natural appearance and strength.
Moreover, the cosmetic dentistry segment has experienced robust growth, especially in emerging economies such as India and Brazil, where there is a growing middle-class population seeking aesthetic enhancements. This trend underscores the growing consumer inclination toward tooth-colored restorations, further reinforcing the role of medical ceramics in dentistry.
A major restraint impeding the growth of the medical ceramics market is the high cost associated with the manufacturing and processing of ceramic materials. Unlike metals or polymers, ceramics require highly controlled production environments, precision machining, and advanced sintering techniques to ensure biocompatibility and structural integrity. These processes significantly increase the overall cost of production, making ceramic-based implants more expensive compared to alternatives like titanium or cobalt-chromium alloys.
Furthermore, the complexity of the production process also limits the scalability of ceramic component manufacturing. Precision grinding and finishing steps are necessary to meet stringent medical standards, which in turn prolongs lead times and adds to production bottlenecks.
As a result, despite the superior performance characteristics of medical ceramics, their high cost and manufacturing challenges act as significant barriers to widespread adoption, particularly in price-sensitive markets across developing regions.
Another key constraint on the growth of the medical ceramics market is the complex and time-consuming regulatory approval process required for introducing new ceramic-based medical devices. Regulatory bodies such as the U.S. Food and Drug Administration (FDA), the European Medicines Agency (EMA), and Japan’s Pharmaceuticals and Medical Devices Agency (PMDA) enforce stringent guidelines to ensure the safety, efficacy, and reliability of implantable materials before they can be commercialized.
Also, manufacturers must comply with evolving international standards such as ISO 13485 for quality management systems and ISO 10993 for biological evaluation of medical devices. Non-compliance can result in delayed approvals or rejection of products, leading to financial losses and missed market opportunities.
According to the MedTech Dive publication, in 2022 alone, nearly 15% of novel medical device applications were either delayed or rejected due to insufficient clinical data or inconsistencies in compliance documentation. These regulatory complexities create a formidable barrier for smaller firms and startups aiming to enter the medical ceramics space, thereby limiting innovation and market expansion.
One of the most promising opportunities for the medical ceramics market lies in the rapid advancements in additive manufacturing (AM) and 3D printing technologies. These innovations are enabling the production of highly customized, patient-specific implants with complex geometries that were previously unattainable using conventional manufacturing methods.
Additive manufacturing allows for the precise layer-by-layer construction of ceramic components, significantly improving design flexibility and reducing material waste. For example, researchers at the Fraunhofer Institute for Ceramic Technologies and Systems have successfully developed 3D-printed ceramic spinal cages that offer enhanced porosity, promoting osseointegration and faster healing. Such breakthroughs are particularly valuable in orthopedics and craniofacial surgery, where anatomical accuracy is crucial.
Moreover, institutions such as the University of Manchester have reported that 3D-printed ceramic scaffolds can mimic natural bone structures, facilitating tissue regeneration and integration. These developments align with the growing emphasis on personalized medicine and minimally invasive surgical techniques, positioning additive manufacturing as a transformative force in the medical ceramics sector.
As AM technologies mature and become more accessible, they are expected to drive down production costs and accelerate the adoption of ceramic implants across both developed and emerging healthcare markets.
Regenerative medicine and tissue engineering represent a burgeoning frontier for the medical ceramics market, offering substantial growth potential beyond traditional implantology. Ceramics such as bioactive glasses, calcium phosphates, and silicon nitride are increasingly being explored for their ability to stimulate cellular activity and support tissue regeneration.
Bioactive ceramics have demonstrated exceptional properties in promoting bone regeneration. For instance, hydroxyapatite a naturally occurring mineral found in human bones, is widely used in bone graft substitutes due to its osteoconductive nature. As per research conducted by the National Center for Biotechnology Information (NCBI), hydroxyapatite-based scaffolds enhance bone cell adhesion and proliferation, making them ideal candidates for treating large bone defects resulting from trauma or disease.
Furthermore, silicon nitride ceramics have gained attention for their antimicrobial properties and ability to promote vascularization, which is essential for successful tissue regeneration. With ongoing research into nanoceramics and composite scaffolds, the medical ceramics industry is well-positioned to play a central role in the next generation of regenerative therapies, opening vast new application areas in wound healing, organ repair, and chronic disease treatment.
One of the foremost challenges facing the medical ceramics market is the inherent brittleness of ceramic materials, which makes them prone to fracture under high mechanical stress. Unlike metals, which exhibit ductile behavior and can deform plastically before failure, ceramics tend to crack or shatter when subjected to sudden impact or repetitive loading. This characteristic poses a significant limitation, particularly in load-bearing applications such as joint replacements and dental implants.
According to a study published in the Journal of the Mechanical Behavior of Biomedical Materials, the fracture toughness of commonly used biomedical ceramics like alumina and zirconia ranges between 3.5 and 5 MPa·m^½, which is considerably lower than that of titanium alloys (approximately 50–60 MPa·m^½). While zirconia exhibits better toughness due to transformation toughening mechanisms, it is still susceptible to low-temperature degradation over time, especially in humid environments within the body.
As per the British Hip Society, while ceramic-on-ceramic hip implants have excellent wear resistance, they carry a small but notable risk of intraoperative or postoperative fracture, estimated at 0.02% to 0.05% of cases. These failures, though rare, can lead to severe complications requiring revision surgery.
Efforts are underway to mitigate this challenge through material composites and nanostructuring techniques. However, until these solutions achieve widespread clinical validation, the intrinsic fragility of ceramics will remain a critical concern for both clinicians and manufacturers operating in this space.
Another pressing challenge confronting the medical ceramics market is the lack of comprehensive long-term clinical data for newer ceramic formulations and composite materials entering the market. While traditional ceramics like alumina and zirconia have well-established clinical histories spanning several decades, emerging variants such as silicon nitride, yttria-stabilized zirconia (YSZ), and bioactive glass ceramics are relatively new in clinical settings.
According to the Cochrane Database of Systematic Reviews, most peer-reviewed studies evaluating the performance of novel ceramic implants have follow-up periods of less than ten years, which is insufficient to fully assess long-term reliability, wear behavior, and biological interactions within the human body. For example, silicon nitride, despite showing promising antimicrobial and osteogenic properties in laboratory studies, lacks extensive longitudinal data to confirm its durability beyond two decades.
This absence of long-term evidence creates hesitancy among surgeons and regulatory authorities when adopting new ceramic materials for widespread use. Also, limited clinical data was a primary reason behind the delayed adoption of certain ceramic composites in spinal fusion procedures.
Without robust, multi-decade clinical evaluations, stakeholders may continue to favor established materials, slowing the uptake of potentially superior ceramic alternatives. Addressing this challenge requires coordinated efforts between academia, industry, and regulatory agencies to conduct extended clinical trials and establish comprehensive performance benchmarks for next-generation medical ceramics.
REPORT METRIC | DETAILS |
Market Size Available | 2024 to 2033 |
Base Year | 2024 |
Forecast Period | 2025 to 2033 |
Segments Covered | By Type, Application, End-user & Region |
Various Analyses Covered | Global, Regional & Country Level Analysis, Segment-Level Analysis, Drivers, Restraints, Opportunities, Challenges; PESTLE Analysis; Porter's Five Forces Analysis, Competitive Landscape, Analyst Overview of Investment Opportunities |
Regions Covered | North America, Europe, Asia Pacific, Latin America, the Middle East, and Africa |
Bioinert ceramics dominated the medical ceramics market in 2024, accounting for 42.3% of total revenue in recent assessments. This segment includes materials such as alumina and zirconia, which are widely used in orthopedic implants, dental prosthetics, and surgical tools due to their chemical stability and minimal interaction with biological tissues.
Moreover, the dominance of bioinert ceramics is primarily driven by their long-standing clinical history and proven performance in load-bearing applications. Their mechanical strength, low wear rates, and resistance to corrosion make them ideal for joint replacements, particularly among aging populations requiring durable solutions.
Furthermore, as per the American Academy of Orthopaedic Surgeons, more than 1 million hip and knee replacement surgeries are performed annually in the U.S. alone. A significant portion of these procedures involves ceramic-on-ceramic or ceramic-on-polyethylene articulations, further reinforcing demand for bioinert ceramics.
Moreover, the increasing preference for minimally invasive surgeries requiring high-performance implant materials has bolstered this segment’s growth. These factors collectively sustain the leadership position of the bioinert ceramics segment in the global medical ceramics market.
Bioresorbable ceramics are emerging as the fastest-growing segment within the medical ceramics market, projected to expand at a CAGR of 9.7% through 2033. This category includes calcium phosphates such as tricalcium phosphate (TCP) and hydroxyapatite, which are designed to degrade gradually after fulfilling their structural or therapeutic role in the body.
One key driver behind this rapid growth is the rising demand for bone graft substitutes in orthopedic and craniofacial surgeries. According to the Journal of Tissue Engineering and Regenerative Medicine, over 500,000 bone grafting procedures are performed annually in the U.S., many of which now incorporate bioresorbable ceramic scaffolds to support natural tissue regeneration.
Furthermore, advancements in bioceramic composites have enhanced mechanical properties while maintaining resorption profiles compatible with physiological conditions. As per researchers from the University of Tokyo, TCP-based implants exhibit complete resorption within 12–24 months post-implantation, replaced by native bone tissue without adverse reactions.
Another factor fueling adoption is the growing incidence of traumatic injuries and complex fractures, especially in developing regions. Also, hospitals and trauma centers increasingly rely on bioresorbable ceramics for temporary fixation and structural support during healing. With ongoing innovations in nanotechnology and composite formulations, the bioresorbable ceramics segment is poised for accelerated expansion across both established and emerging healthcare markets.
Implants represented the largest application segment in the medical ceramics market in 2024, capturing 58.1% of total revenue. This segment encompasses orthopedic, dental, and cardiovascular implants made from advanced ceramic materials such as zirconia, alumina, and silicon nitride.
The dominant position of implants is largely attributed to the increasing prevalence of musculoskeletal disorders and degenerative diseases. According to the International Osteoporosis Foundation, over 200 million people worldwide suffer from osteoporosis, leading to an increased risk of fractures and subsequent demand for joint replacements. Also, as per estimations from the American Academy of Orthopaedic Surgeons, more than 1 million joint replacement surgeries are conducted annually in the United States alone, with a growing share incorporating ceramic components.
Dental implantology also significantly contributes to this segment’s growth. Furthermore, according to the World Dental Federation, tooth loss affects over 3.5 billion individuals globally, driving the need for durable and esthetically pleasing implant solutions.
Technological advancements in ceramic manufacturing, including additive techniques and CAD/CAM processing, have enabled greater precision and customization in implant design. These developments enhance patient outcomes and reduce the likelihood of implant failure, reinforcing the sustained dominance of the implants segment in the medical ceramics industry.
The medical devices are expected to grow at the fastest pace, with a projected CAGR of 8.4% through 2033. This category includes surgical instruments, ablation catheters, sensors, and diagnostic equipment that incorporate ceramic components for their insulating, piezoelectric, and biocompatible properties.
A primary driver of this growth is the expanding use of ceramics in minimally invasive surgical devices. The increasing number of endoscopic and robotic-assisted surgeries further amplifies demand for high-performance ceramic components.
Besides, the proliferation of wearable and implantable medical electronics has spurred interest in piezoceramic materials for sensor applications. The National Institute of Biomedical Imaging and Bioengineering reports that over 15 million patients in the U.S. currently use cardiac rhythm management devices, many of which employ ceramic capacitors and transducers.
Moreover, the global push toward telemedicine and remote diagnostics has led to the development of compact, high-efficiency medical sensors, where ceramics play a critical role in ensuring signal integrity and durability. With continuous innovation in device miniaturization and smart health technologies, the medical devices segment is set for robust expansion in the coming decade.
Hospitals and clinics constituted the largest end-user segment in the medical ceramics market in 2024, holding 64.6% of total market share. These institutions serve as the primary points of care for patients undergoing orthopedic, dental, and cardiovascular procedures that require ceramic-based implants and devices.
This dominance is primarily fueled by the increasing volume of surgical interventions taking place in hospital settings. Also, major hospitals in developed countries like the U.S., Germany, and Japan have integrated advanced ceramic implants into standard treatment protocols for joint replacements and dental reconstructions.
According to the American Hospital Association, there are over 6,000 registered hospitals in the United States, with an average of 1,000 surgical procedures conducted per facility annually. Many of these surgeries involve ceramic-based products such as hip implants, dental crowns, and pacemaker components.
Apart from these, the rise in healthcare expenditures and insurance coverage for elective procedures has improved access to ceramic-based treatments. As per the Organisation for Economic Co-operation and Development (OECD), healthcare spending in high-income countries exceeds USD 4,000 per capita annually, supporting the adoption of premium medical ceramics in hospital environments.
With continued investments in surgical infrastructure and digital health integration, hospitals and clinics remain the cornerstone of medical ceramics consumption globally.
Surgical centers, including ambulatory surgical centers (ASCs) and specialty clinics, are the fastest-growing end-user segment in the medical ceramics market, anticipated to grow at a CAGR of 9.1% in the coming years. These facilities offer outpatient surgical services, often specializing in orthopedic, dental, and cosmetic procedures that increasingly utilize ceramic-based implants and instruments.
One of the main drivers behind this growth is the shift toward cost-effective, minimally invasive procedures performed outside traditional hospital settings. According to the Ambulatory Surgery Center Association, over 23 million procedures were conducted in ASCs across the United States in 2022, with orthopedic and dental interventions accounting for a substantial portion.
The Centers for Medicare & Medicaid Services (CMS) has expanded reimbursement policies for certain outpatient surgeries, encouraging patients and providers to opt for surgical centers instead of inpatient hospital admissions. This trend reduces overall healthcare costs and increases procedural efficiency.
Moreover, surgical centers benefit from streamlined regulatory pathways for adopting new medical technologies. As healthcare systems continue to prioritize efficiency and patient convenience, surgical centers are emerging as key growth engines for the medical ceramics market.
North America holds a commanding regional share in the medical ceramics market in 2024, accounting for 35.5% of total revenue. The U.S. dominates this region due to its well-established healthcare infrastructure, high adoption of advanced medical technologies, and strong presence of key manufacturers.
A key growth driver in the U.S. is the rising incidence of musculoskeletal disorders. According to the Centers for Disease Control and Prevention (CDC), more than 54 million adults in the U.S. suffer from arthritis, contributing to a surge in orthopedic implant procedures. Also, as per the American Dental Association, over 3 million dental implants are placed annually in the country, with ceramic options gaining traction for their aesthetic and biocompatible properties.
Moreover, North America benefits from favorable reimbursement policies and a robust pipeline of R&D initiatives. Coupled with a high healthcare expenditure, the U.S. remains the epicenter of medical ceramics innovation and adoption.
Europe remains a key player in the global medical ceramics market. Germany leads the European region due to its advanced healthcare system, stringent product quality standards, and a strong focus on orthopedic and dental applications.
Germany's position is underscored by its high volume of joint replacement surgeries. The widespread use of ceramic-on-ceramic implants in these procedures has contributed significantly to market growth.
In addition, Europe benefits from proactive government funding for biomedical research. The European Commission reports that Horizon Europe allocates over EUR 1 billion annually to health-related R&D projects, including advanced biomaterials. Regulatory harmonization under the Medical Device Regulation (MDR) framework has also streamlined approvals for novel ceramic implants. With a rapidly aging population where one in five citizens is aged 65 or older demand for durable, high-performance medical ceramics is expected to remain strong, sustaining Europe’s prominent market position.
Asia Pacific is the fastest-growing region, driven by rapid urbanization, improving healthcare access, and rising disposable incomes. China stands out as the leading contributor within this region.
China's medical ceramics market is expanding due to a combination of government investment in healthcare infrastructure and an aging demographic profile. According to the National Bureau of Statistics of China, the elderly population (aged 60 and above) reached 280 million in 2022, increasing the demand for orthopedic and dental implants.
As per the Chinese Ministry of Science and Technology, over USD 2 billion has been allocated to biomedical material research between 2020 and 2025, fostering domestic innovation in ceramic implants. Also, the country has become a hub for contract manufacturing and technology collaborations with global players.
With rising medical tourism and increasing insurance coverage, China is poised to drive sustained growth in the Asia Pacific medical ceramics market.
Latin America represents an emerging market in the medical ceramics sector. Brazil is the most influential player in the region, benefiting from a growing middle class and expanding private healthcare sector.
Brazil’s healthcare expenditure has risen steadily. This increase has supported the adoption of advanced implantable materials, including ceramics, particularly in urban centers like São Paulo and Rio de Janeiro. Moreover, the country has implemented policies to encourage local manufacturing of medical devices, reducing import dependency.
Despite economic fluctuations, Brazil continues to invest in healthcare modernization, positioning Latin America as a promising growth region for medical ceramics.
The Middle East and Africa region is a niche medical ceramics market, with Saudi Arabia emerging as the key market leader in the region. The country’s healthcare sector is undergoing rapid transformation, supported by Vision 2030 initiatives aimed at diversifying the economy and enhancing healthcare accessibility.
Saudi Arabia has significantly increased healthcare spending. The government has invested in state-of-the-art hospitals and medical research centers, fostering the adoption of high-quality implant materials. Also, the country has introduced regulatory reforms to expedite medical device approvals, attracting foreign investments.
While still a niche market, the Middle East and Africa region presents untapped potential for medical ceramics, particularly in Gulf Cooperation Council (GCC) nations where healthcare modernization is a strategic priority.
3M ESPE, CoorsTek Inc., DePuy Synthes, H.C. Starck GmbH, Kyocera Corporation, Morgan Advanced Materials, Nobel Biocare Services AG, Straumann, Stryker, and Zimmer Biomet are a few of the prominent companies operating in the global medical ceramics market profiled in this report.
One of the leading players in the medical ceramics market is CeramTec GmbH. The company has a strong global presence and offers a broad portfolio of ceramic components used in orthopedics, dental implants, and surgical instruments. Known for its innovation and precision engineering, CeramTec plays a pivotal role in advancing high-performance ceramic solutions tailored to meet evolving clinical needs. Its focus on R&D ensures continuous development of biocompatible and durable implant materials that cater to both established and emerging markets.
Another major contributor is Kyocera Corporation, a Japanese conglomerate with a dedicated division specializing in advanced ceramics for medical applications. Kyocera has been instrumental in pioneering ceramic hip joint components and dental restorations, combining decades of material science expertise with cutting-edge manufacturing techniques. The company's commitment to quality and long-term reliability has made it a trusted name among surgeons and dental professionals worldwide.
CoorsTek Inc. is also a key player, recognized for its extensive range of technical ceramics used across various medical fields. With a focus on customized solutions, CoorsTek delivers ceramic parts for implants, diagnostic devices, and surgical tools. Their strategic collaborations with research institutions and healthcare providers enable them to stay at the forefront of technological advancements, ensuring their products meet stringent medical standards while supporting improved patient outcomes.
A primary strategy employed by leading players in the medical ceramics market is product innovation and R&D investment. Companies are continuously developing advanced ceramic materials with enhanced mechanical properties, biocompatibility, and integration capabilities to meet evolving clinical demands. These efforts help firms differentiate their offerings and maintain a competitive edge.
Another crucial approach is strategic partnerships and collaborations with academic institutions, medical device manufacturers, and regulatory bodies. Such alliances facilitate knowledge exchange, accelerate product development cycles, and streamline regulatory approvals, enabling faster commercialization of novel ceramic-based solutions.
Lastly, expansion into emerging markets through localized manufacturing and distribution networks is a key growth strategy. By establishing regional footholds, companies can better serve growing demand in Asia Pacific, Latin America, and the Middle East, while reducing logistical costs and improving supply chain efficiency.
The medical ceramics market is characterized by intense competition driven by technological innovation, product differentiation, and expanding application areas. Several large multinational corporations dominate the industry, leveraging their extensive R&D capabilities and global distribution networks to maintain leadership positions. However, increasing participation from regional players and startups is reshaping the competitive dynamics, particularly in emerging economies where cost-effective solutions are in high demand. Strategic mergers and acquisitions have become common as companies seek to enhance their product portfolios and gain access to new markets. Additionally, collaboration with academic and research institutions is playing a crucial role in accelerating the development of next-generation ceramic materials with superior performance characteristics. As the demand for bioresorbable and piezoceramic materials grows, firms are investing heavily in advanced manufacturing techniques such as additive manufacturing to improve customization and reduce production lead times. This evolving landscape necessitates continuous innovation and adaptability, ensuring that only those with robust technological capabilities and agile business strategies can sustain long-term success in this highly specialized sector.
This market research report on the global medical ceramics market has been segmented and sub-segmented based on the type, application, end-user & region.
By Type
By Application
By End-User
By Region
Frequently Asked Questions
As per our research report, the global medical ceramics market size is estimated to be worth USD 27.92 billion by 2033.
Yes, in this report, the COVID-19 impact on the global medical ceramics market is included.
The APAC region accounted for the most significant share of the medical ceramics market in 2024.
Companies playing a key role in the global medical ceramics market are M ESPE, CoorsTek Inc., DePuy Synthes, H.C. Starck GmbH, Kyocera Corporation, Morgan Advanced Materials, Nobel Biocare Services AG, Straumann, Stryker, and Zimmer Biomet.
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